Possibly Still There?

[ToastedOne]

Back in October, I wrote you about urinary issues under the name ToastedOne.  I got all the tests for STDs which all came back negative.  I also took every antibiotic under the sun.  I have had continued mild irritation at the tip of the penis, periodic restricted urine stream and a slight pain the scrotum.  My doctor examined me and diagnosed nonbacterial prostatitis and I got two months of Levaquin (I am also 38 yrs old).  Symptoms have returned thus I have been reading about NBP on the web.  It is believed that bacteria filled absesses on the prostate that the antibiotics cannot penetrate may be the cause and many docs point to STDs as the cause.  Being married, the notion of an STD locked away in my prostate scares me.  If true, could an absess leak and re-infect me? If the original PCR urine tests were negative, could an STD micro-organism be in my prostate and the tests missed it?  I'm not sure what to do or even if I need to be worried.  FYI, wife has never had any complaints.  Lastly, what about Trich?  I understand my age group does not have it very ofter and women can be asymptomatic.  But it can last for years in the system, it that very common? I've read that the majority of women show symptoms rather quickly and it's been 8 months.  Does "majority" translate to 51% or 99%?

[H. Hunter Handsfield, M.D.]

Your symptoms still do not suggest STD.  Not knowing the basis for the diagnosis of prostatitis it is hard to comment, but I will point out that it's often a "wastebasket" diagnosis when a provider cannot otherwise explain vague genital symptoms in men.  There is no such thing as an "STD locked away in the prostate".  The natural course of untreated trichomoniasis in men usually is spontaneous cure over a few weeks to months, so it really isn't an issue and in any case does not cause the sort of symptoms you describe.



Two days ago I posted the following in an other thread (http://www.medhelp.org/forums/STD/messages/3025.html).  I have the feeling I'm going to be using it a lot.  Here it is:



It is a fact of life that human beings get various aches and pains. Out of the blue there is knee pain, a headache, abdominal discomfort, a stich in the side, tingling down a leg. Sometimes such problems are continuing or recurrent, yet no specific cause ever is found and clearly no important infection or disease is present.



Why should the genital area be any different? Not every symptom means disease. People with such symptoms of course should see a health care provider. But when a comprehensive evaluation comes up with no good explanation for genital symptoms, and if they persist after treatment of the potential infectious causes, it is wrong to assume a serious health problem. Just as some people have to learn to live with unexplained but benign headaches or abdominal pain, others have to live with unexplained genital symptoms.



Our genitals have a special place in our psyches, and unexplained discomfort can be harder to ignore than for a joint or even the head. But the principle holds. It's fine to look for harmless things that might help control symptoms. But potentially harmful treatments (e.g., repeated high doses of antibiotics, potent pain controllers) make no sense, and doctor-shopping (or internet shopping) for different answers generally is fruitless.



I hope this helps.  Good luck--  HHH, MD

[ToastedOne]

Thanks, Doc.  I appreciate the last part about aches and pains, I guess the hard part is that a headache does not generally cause divorce.  If I may, the trich question I had relates to the females.  Is it rare or common for women to be asymptomatic for long periods of time?  Such as 8 months or longer?  Then wake-up one morning with trichomoniasis?

[H. Hunter Handsfield, M.D.]

Trich sometimes shows up in women years after presumed acquisition.  A common scenario is detection of asymptomatic infection in middle-aged women when they get nonspecific symptoms around the time of menopause.  What proportion of those infections are sexually acquired, and when, is totally unknown.  Some of them might be colonization of the vagina with related organisms that are normal in feces (e.g., Trichomonas hominis, not vaginalis).



For you, the two take-home points are:  1) It is virtually certain you do not have it; and 2) if you do and it pops up someday in your wife, her doc will not necessarily assume you were a (recent) source of her infection.  In other words, there is a measure of protection against the potential accusation of infidelity.



I suggest you just drop the whole thing.  You're never going to get any more clear answers than you already have.



HHH, MD

[Aquaman]

Its been exactly the same for me for nearly a year now. Tests all come back negative, but something is wrong. Its extremely disconcerting researching prostatitis on the internet--- there seems to be no agreement,  a lot of quackery. no answers. Just when I start to feel a little more zen about things, Ill read something new that makes me s**t my pants.

[ToastedOne]

Hey Aquaman, I know what you mean.  I have never been tested positve for anything yet I have a slight irritation in my urethra.  I went online to "ask.com" and typed in nonbacterial prostatitis cures and some interesting sites came up.  A clinic in the Phillipines and an off-shoot in Tucson claim there is no nonbacterial prostatitis and that there is an infection.  Most likely the VD type hidden in absesses that anti-biotics cannot get to.  Great, huh?

[Science]

Yep, I have the same problems and have found help from www.chronicprostatitis.com